Coupling devices for interventional delivery systems and methods of using such coupling devices

ABSTRACT

A coupling device, set to be linked to an interventional delivery system, for coupling and releasing a medical implant. The coupling device comprises a generally tubular channel sized and shaped to be conducted in an intravascular catheter and a pivot extended in and along the generally tubular channel having a distal end comprising a lower surface for applying pushing force a medical implant and an upper surface, mounted above the lower generally tubular surface and having at least one niche for receiving at least one anchoring element of the medical element so that a tip of each the anchoring element is placed between the lower and upper surfaces.

RELATED APPLICATIONS

This application claims the benefit of priority under 35 USC 119(e) ofU.S. Provisional Patent Application Nos. 61/302,141 and 61/302,143, bothfiled on Feb. 7, 2010. The contents of the above applications areincorporated herein by reference in their entirety.

FIELD AND BACKGROUND OF THE INVENTION

The present invention, in some embodiments thereof, relates to methodsand devices for delivery of medical implants and, more particularly, butnot exclusively, to methods and devices for delivery of medical implantsinto an intravascular lumen.

Various systems for delivery of vascular medical implants have beendevised over the years in order to assist physicians in the implantationprocess within a patient, preferably in a minimally invasive manner.Most of the delivery systems include an elongated catheter that is usedto access various passageways inside a patient's body.

Implants may include devices designed for compression into a small sizetube or catheter to facilitate their introduction into the vasculatureof the patient. The implants are subsequently expandable either toocclude defects or to contact the walls of the blood vessels.

A number of coupling devices have been developed to release the implantat the intravascular target area. An example for such a coupling deviceis described in U.S. Patent Application No. 2008/0154302, filed on Mar.3, 2008, which describes a coupling device which is disposed at thedistal end of an interventional delivery system for coupling to animplant. The coupling device has a first and second prong connected atone end. The other end of the prongs opens or closes to release or trapan object, e.g., a bead tethered from an implant. A slot at the distalend of the coupling device allows extra degrees of flexibility for thecoupling device.

SUMMARY OF THE INVENTION

According to some embodiments of the present invention, there isprovided a coupling device set to be linked to an interventionaldelivery system, for coupling and releasing a medical implant. Thecoupling device comprises a generally tubular channel sized and shapedto be conducted in an intravascular catheter and a pivot extended in andalong the generally tubular channel having a distal end comprising alower surface for applying pushing force on a medical implant and anupper surface, mounted above the lower generally tubular surface andhaving at least one niche for receiving at least one anchoring elementof the medical element so that a tip of each the anchoring element isplaced between the lower and upper surfaces.

Optionally, the generally tubular channel is sized and shaped to coverthe pivot and the medical implant so as to fasten the at least oneanchoring element between the upper and lower generally tubularsurfaces.

Optionally, the pivot is coated with a polymer to provide a supportivestructure.

Optionally, the medical implant is coupled to the pivot without anddirect mechanical connection.

Optionally, the pivot is mechanically connected to a control mechanismfacilitating the retrieving or repositioning of the medical implant intothe generally tubular channel.

Optionally, the pivot is mechanically connected to a safety mechanismfor requiring a verification action of the user before a deployment ofthe medical implant.

Optionally, the distal end is curved so that the tip is directedsubstantially toward the upper surface when respective the anchoringelement being placed between the lower and upper surfaces.

According to some embodiments of the present invention, there isprovided a method for coupling a medical implant. The method comprisesproviding a coupling device comprising a generally tubular channel sizedand shaped to be conducted in an intravascular catheter and a pivotextended in and along the generally tubular channel having a distal endcomprising substantially parallel lower and upper surfaces having a gaptherebetween, the upper surface having at least one niche, placing atleast one anchoring element of a medical implant in proximity to thedistal end so that at least a tip of the at least one anchoring elementimplant is placed between the lower and upper surfaces and so that theat least one anchoring element passing through the upper surface andencircling the medical implant using the generally tubular channel.

Optionally, the medical implant has an elastic blocking element havingcompressed and uncompressed states, the encircling comprising coveringthe elastic blocking element in the compressed state.

More optionally, the method further comprises uncovering the at leastone anchoring element so as to allow outward tilting thereof.

More optionally, the medical implant is discoupled by: uncovering the atleast one anchoring element, and rotating the pivot in relation to thegenerally tubular channel.

More optionally, the placing comprises: attaching an implant adaptorcontaining the medical implant in front of distal end of the generallytubular channel, performing the placing, and pulling the pivot into thegenerally tubular channel.

According to some embodiments of the present invention, there isprovided a coupling device set to be linked to an interventionaldelivery system, for coupling and releasing a medical implant. Thecoupling device comprises a generally tubular channel sized and shapedto be conducted in an intravascular catheter and a pivot extended in andalong the generally tubular channel having a distal end comprising afastening element for coupling with a complementary fastening element ofa medical implant.

Optionally, the pivot, the fastening element, and the complementaryfastening element have a common diameter.

Unless otherwise defined, all technical and/or scientific terms usedherein have the same meaning as commonly understood by one of ordinaryskill in the art to which the invention pertains. Although methods andmaterials similar or equivalent to those described herein can be used inthe practice or testing of embodiments of the invention, exemplarymethods and/or materials are described below. In case of conflict, thepatent specification, including definitions, will control. In addition,the materials, methods, and examples are illustrative only and are notintended to be necessarily limiting.

BRIEF DESCRIPTION OF THE DRAWINGS

Some embodiments of the invention are herein described, by way ofexample only, with reference to the accompanying drawings. With specificreference now to the drawings in detail, it is stressed that theparticulars shown are by way of example and for purposes of illustrativediscussion of embodiments of the invention. In this regard, thedescription taken with the drawings makes apparent to those skilled inthe art how embodiments of the invention may be practiced.

In the drawings:

FIG. 1 is a coupling device disposed at the distal end of a catheter ofan interventional delivery system, according to some embodiments of thepresent application;

FIGS. 2A and 2B are lateral and top schematic illustrations of acoupling device, according to some embodiments of the present invention;

FIGS. 3A-3D are schematic illustrations of various components and anglesof another exemplary coupling device, according to some embodiments ofthe present invention;

FIGS. 4A-4D which are schematic illustrations of various components andangles of a similar coupling device, with different fastening elements,according to some embodiments of the present invention;

FIG. 5 is a flowchart of a method of placing a medical implant in alumen of a blood vessel using an interventional delivery system, such asdepicted in FIG. 1, according to some embodiments of the presentinvention;

FIG. 6 is a schematic expanded view of a section of a catheter having anexemplary implant holding portion and an adaptor containing a medicalimplant, in accordance with an exemplary embodiment of the invention;

FIG. 7 is a graphic illustration of a section of the catheter whichfunctions as a magazine, in accordance with an exemplary embodiment ofthe invention; and

FIGS. 8A-8D are graphic illustrations of various aspects of pivotholding apparatus section of a delivery rod handle, in accordance withan exemplary embodiments of the invention.

DESCRIPTION OF EMBODIMENTS OF THE INVENTION

The present invention, in some embodiments thereof, relates to methodsand devices for delivery of medical implants and, more particularly, butnot exclusively, to methods and devices for delivery of medical implantsinto an intravascular lumen.

According to some embodiments of the present invention, there areprovided coupling devices, which are set to be linked to aninterventional delivery system, for coupling and releasing medicalimplants, and methods of using thereof. For example, the coupling deviceincludes a generally tubular channel sized and shaped to be conducted inan intravascular catheter and a pivot extended in and along thegenerally tubular channel. The pivot has a distal end with a lowersurface for applying pushing force a medical implant and an uppersurface having niche(s) for receiving anchoring element(s), such aselastic hooks, of a medical element, such as a blood vessel occludingimplant. The surfaces are set so that a tip of each anchoring elementmay be placed in a gap therebetween and the generally tubular channelmay be placed to encircle the gap. Another example is a coupling devicehaving the generally tubular channel and a pivot having a distal endwith a fastening element for coupling with a complementary fasteningelement of a medical implant. In this exemplary embodiment, the pivot,the fastening element, and the complementary fastening element have acommon diameter.

Some embodiments of the present invention describe the control mechanismthat allows releasing medical implants from such coupling devices.

Before explaining at least one embodiment of the invention in detail, itis to be understood that the invention is not necessarily limited in itsapplication to the details of construction and the arrangement of thecomponents and/or methods set forth in the following description and/orillustrated in the drawings and/or the Examples. The invention iscapable of other embodiments or of being practiced or carried out invarious ways.

Referring now to the drawings, FIG. 1 illustrates a location 199 of acoupling device, in accordance with some embodiments of the presentapplication. The coupling device is disposed in a catheter 110 of aninterventional delivery system 100 and provides a mechanism for couplingand releasing a medical implant 170 (partly shown) during animplantation process. The medical implant 170 has one or more anchoringelements, such as hooks, for anchoring it in an intravascular lumen. Forexample the medical implant 170 is a blood vessel occluding device, forexample as defined in co-filed international patent application to ZeevBrandeis, titled intravascular devices for treating blood vessels and amethod of using such devices, which the content thereof is incorporatedherein by reference.

The coupling device includes a delivery rod 125 having a pivot 155 and asubstantially tubular channel 121 which is set to be threaded in acatheter 110 of the interventional delivery system 100. The pivot 155 isextended along the generally tubular channel 110 and set to applypushing force on the medical implant 170 that is coupled at its distalend, for example as described below. The pivot 155 is optionally coveredby a strengthening polymer, such as nylon. The coupling device is set tolock the anchoring elements in an openable space which is formed betweenthe pivot 155 and the substantially tubular channel 121.

As further described below, the proximal end of the pivot 155 isfunctionally coupled to a delivery control apparatus so as to allowusing the pivot 155 for guiding and deploying the medical implant 170that is connected thereto to a intravascular target area in a targetblood vessel, such as a vein, during a treatment, such as a varicosevein treatment, sclerotherapy and/or the like.

Reference is now also made to FIGS. 2A and 2B, which are lateral and topschematic illustrations of the distal end of a coupling device 400,according to some embodiments of the present invention. As shown atFIGS. 2A and 2B, the medical implant 170 has a plurality of anchoringelements 450. The anchoring elements 450 optionally have tilted andsubstantially vertical states. In the tilted state, the anchoringelements 450 are inclined away from the pivot 410 and in thesubstantially vertical state the anchoring elements 450 aresubstantially parallel to the pivot 410 (numeral 155 in FIG. 1). Whilethe vertical state allows placing the medical implant 170 in thegenerally tubular channel 405 (numeral 121 in FIG. 1), the tilted stateallows anchoring the medical implant 170 to the walls of the targetblood vessel, for example as defined in co filed international patentapplication to Zeev Brandeis, titled intravascular devices for treatingblood vessels and a method of using such devices, which the contentthereof is incorporated herein by reference. Optionally, the anchoringelements 450 are constructed from shape memory materials, such as nickeltitanium (Nitinol), to enable automatic switch between the states in anintravascular target area according to a controlled degree. At thedistal end of the pivot 410, the coupling device 400 includes upper andlower plates 425, 430 having a gap 444 therebetween. For example, thepivot 410 may be permanently or detachably connected or coupled to theupper and lower plates 425, 430 and/or to a support element that isconnected to the upper and lower plates 425, 430. The advancing and/orretrieving of the pivot 410 advances and/or retrieves the upper andlower plates 425, 430 and therefore advances, repositions and/orretrieves any element that is held in the gap 444. The gap 444 is sizedto allow locating the distal ends of the anchoring elements 450, in avertical state between the upper and lower plates 425, 430 so that, inuse, for example during the release of the medical implant, the lowerplate 430 applies pushing force on the anchoring elements 450 while theupper plate 425 covers the tips 436 of the anchoring elements 450. Forexample, FIG. 2B provides a cross sectional view of the tubular channel405, where the distal end 435 of the anchoring elements 465 aredepicted. As can be seen, the anchoring elements 450 pass via the upperplate 425 at points 460 and may be temporarily connected in a restingposition, to prevent penetration of anchor tips 436 to surroundingvessels and/or blood vessel walls.

The medical implant 170 is coupled to the coupling device 99 when theanchoring elements 450 are locked between the upper and lower plates425, 430 and the encircled by the tubular channel 405. It should benoted that in this embodiment, as the anchoring elements 450 are lockedbetween the upper and lower plates 425, 430, the medical implant 170 iscoupled to the pivot 410 without any direct mechanical connection. Forexample, when a practitioner loads the medical implant onto theinterventional delivery system 100, she withdraws the generally tubularchannel 405 to expose the gap 444 and places the distal end 435 of theanchoring elements 450 in the gap 444. Optionally, the upper plate 425includes grooves 445 which allow threading the anchoring elements 450therethrough, for example as shown at FIG. 2A. The upper and lowerplates 430, together with the wall of the generally tubular channel 405,holds the anchoring elements 450 locked in the gap 444. In such amanner, the anchoring elements 450 may be released when the generallytubular channel 405 is retrieved from being placed in line with the gap444, for example by retrieving the generally tubular channel 405 whilemaintaining the pivot 410 in place or pushing the pivot 410 whilemaintaining the generally tubular channel 405 in place. During theimplantation, the withdrawing of the tubular channel 405 may be done bypulling the generally tubular channel 405 while holding the pivot 410 inposition, by manipulating the pivot grip 345, the safety pin 160, and/orthe delivery rod handle 135, for example as described.

Reference is now also made to FIGS. 3A-3D, which are schematicillustrations of various components and angles of another exemplarycoupling device 599, according to some embodiments of the presentinvention. Reference is also made to FIGS. 4A-4D, which are schematicillustrations of various components and angles of a similar couplingdevice 699, according to some embodiments of the present invention. Asdepicted in FIG. 3A/4A, and similar to the described above, the couplingdevice 599/699 is connected to the distal end of the pivot 510/610. Asfurther described below, the proximal end of the pivot 510/610 isfunctionally coupled to a delivery control apparatus, for example asdepicted in FIGS. 9A-9D. As depicted in FIG. 3B/4B, the distal end ofthe pivot 510/610 is coupled or comprises a first fastening element533/633, such as a hook, for fastening, for example hooking onto asecond fastening element/634, such as complementary hook, which is inproximity to anchoring element 540/640 of the medical implant 170. Asdepicted in FIG. 3B, the fastening elements 533 534 may be a groove,optionally triangular and a loop or vice versa, and/or, as shown at FIG.4B, the fastening elements 633 634 may be two grooves, optionallyrectangular which are complementary to one another. Fastening elements533/633 and 534/634 are designed to be connected before initiating atreatment session, until the practitioner manipulates a pivot grip,safety pin, and/or a delivery rod handle, as described below withreference to FIGS. 9A-9D. The connection between the fastening elements533/633 and 534/634 allows retrieving, repositioning and/or pushing themedical element 170. The fastening elements 533/633 and 534/634 aredisconnected from one another after the anchoring elements 540/640 ofthe medical implant 170 are released into a deployment position. In someembodiments, the diameter of the fastening elements 533/633, 534/634,when they hold on another, is similar to the diameter of the pivot 510.Optionally, one or more of the fastening elements 533/633 534/634 areoptionally made of metal, such as Nitinol for strengthening theconnection therebetween. Of course, other shapes or types of hooking,attaching or locking mechanisms may be used.

FIGS. 3C/4C provides a magnified horizontal cross sectional view, orprofile, of the generally tubular channel 505/605, where the pivot 510and the anchoring elements are depicted. Each figure depicts anexemplary pivot groove 555/655 and anchoring elements recesses 550/650.

FIG. 3D/4D provides a graphical perspective of the lumen of thegenerally tubular channel 505/605 at the area of the coupling devices,which enables strengthening the connection between fastening elements533/633 and 534/634. The width of this segment may be between 5millimeter (mm) and 15 mm.

Reference is now made, once again, to FIG. 1 and to FIG. 5, which is aflowchart of a method 500 of placing a medical implant in a lumen of ablood vessel using an interventional delivery system, such as depictedin FIG. 1, according to some embodiments of the present invention. Themethod is based, as shown at 551 on an interventional delivery system,such as 100, which includes a coupling device with delivery rod having atubular channel and a pivot having a distal end, for example as depictedin FIGS. 2A and 2B.

As shown at 552, a medical implant, such as 170 is loaded onto theinterventional delivery system 100, for example coupled to the couplingdevice thereof. During the loading, anchoring elements of the medicalimplant are optionally placed in a locking space of the coupling devicewhere the distal ends of the anchoring elements are locked between upperand lower plates and the walls of the catheter 405 or as depicted inFIGS. 3A-3D and/or FIGS. 4A-4D where the distal ends of the anchoringelements are locked only by the walls of the catheter 405.

The loading is optionally done using an adaptor. In the interventionaldelivery system 100 depicted in FIG. 1 the distal end of the catheter405 is connected to an adaptor 105 that is sized and shaped for holdingthe medical implant 170 prior to the loading thereof into theinterventional delivery system 100. The adaptor 105 is optionally usedas a container which encapsulates the medical implant 170 until openingof the package or kit which includes the delivery system 100. During theloading process, the adaptor 105 is placed at the distal end of thecatheter 405. Then, the medical implant 170 is pulled into the catheter,optionally to an implant holding portion 112, such as a magazine, forexample by a wire, such as the pivot 410. Once the medical implant 170is in the implant holding portion 112, the adaptor is removed.

For example, reference is made to FIG. 6, which is a schematicillustration which depicts an expanded view of a section of a couplingdevice, in a catheter having an exemplary implant holding portion 200and an adaptor 205, containing a medical implant 270, which is at astorage state and connected to the distal end of the catheter. As can beseen, the adaptor 205 is initially coupled to magazine holder 210 by aclick connector 225. Once medical implant 270 is transferred into theholding section 212, where it may remain in a pre-deployment position,the adaptor 205 may be disconnected and discarded.

Reference is now made, once again, to FIG. 1. The holding section,referred to herein also as a magazine 112, is adapted to be loaded withthe medical implant 170. For example, reference is also made to FIG. 7,which is a graphic illustration of a section of the catheter 200 whichfunctions as a magazine, in accordance with an exemplary embodiment ofthe invention. As can be seen in FIG. 7, an implant holding portion or agrip 210 is designed for pulling or maneuvering the medical implant 170from the adaptor 105 into a container area 212. The holding section 200is typically coupled to a controllable haemostatic valve 220, a maleLuer lock 215, and a click connector 225 to connect/disconnect theadaptor 105 and/or various introducing catheter elements or sheaths (notshown). Click connector 225 may be adapted to be used with differenttypes of hubs and/or Luer Lock connectors. In some embodiments the clickconnector is connected with a holding cup and then with an introducingcatheter or other catheter.

As shown at 553, after the medical implant 170 has loaded, for exampleinto the magazine 112, it is conducted to an intravascular target areaalong one or more paths passing via one or more intrabody lumens, suchas blood vessels. Then, it is released at the intravascular target area,as shown at 554. The conducting and the releasing are performed usingthe interventional delivery system 100.

Optionally, the conducting of the medical implant into the intravasculartarget area is supported by a practitioner that uses an Ultra soundtracking system to decide upon an entry point for the procedure. Forexample, a Micro Puncture set may be used to enter below the knee and/orabove ankle using Ultra sound navigation. The micro puncture sheet maythen be extracted, and a guiding wire may be inserted. For example, a0.38 J guiding wire may be inserted into the Safenous vein, under Ultrasound guidance, until the desired location has been reached. Thepractitioner may then insert an introducing catheter and a dilator, suchas cook flexor 6F, until the target area has been reached, typicallydistal to the desired location. The guide wire may then be retractedwith the Dilator together.

Optionally, the interventional delivery system 100 includes a port 115,such as a side port, with three way stop cock 116 and Luer lock 117 forflushing, injecting or suctioning of liquids or other materials isconnected to the magazine 112. This side port 115 may be used forconnecting to one or more delivery syringes and/or catheters. A rotatingscrew, such as TBV Valve 120, is provided, to create a hermetic sealwhich enables connecting and/or disconnecting delivery catheterextension(s). A delivery rod 125 encased by delivery or introducercatheter portion 127 is provided. The delivery rod 125 includes theaforementioned pivot 155, which may be covered and/or coated, forexample, by a polymer, to provide a supportive structure. As describedabove, the distal end of the pivot 155 is coupled to the medical implant170 and the proximal end thereof is connected to a pivot holdingapparatus. Optionally, the pivot holding apparatus includes a safetylatch 130 to prevent releasing of the pivot 155 from the channel ofdelivery rod 125, and/or to stop unintended or premature releasing ordeploying of the delivery rod from the delivery catheter. A delivery rodhandle 135, delivery rod female Luer lock 140, and a pivot grip 145 witha pivot gripping mechanism 150 are provided, to enable controlledlocking and releasing actions. A safety pin 160 may be used to preventthe release of grip 145 from rod handle 135, to prevent prematurerelease of the medical implant 170 from the delivery rod, prior to finaldeployment. Delivery rod handle 135 is typically connected to distalback part of the delivery rod 125.

A practitioner releases the medical implant 170 by manipulating, forexample rotating, the delivery rod handle 135. The man manipulationreleases the coupling between the medical implant and the distal end ofthe pivot. For example, reference is now made to FIGS. 8A-8D, which aregraphic illustrations of various aspects of pivot holding apparatussection of the delivery rod handle 135, in accordance with someembodiments of the present invention. As can be seen in FIG. 8A, thepivot holder includes A safety latch 330 which may be used to stopunintended or premature releasing of the medical implant 170 from thepivot of rod 355, a delivery rod handle 335, and a delivery rod femaleLuer Lock housing 340. The Luer Lock housing 340 may be adapted to beused with a variety of Luer Locks and Luer Lock connectors. FIG. 8Bdepicts a pivot grip 345 that enables controlled locking and releasingactions and pivot anchoring element 380, to fasten the end of the pivot,to prevent unintended deployment or release; and a safety pin 360 forsecuring final deployment of the medical implant 170. As can be seen inFIGS. 8B and 8C, safety pin 360 may be used to prevent the release ofgrip 345 from rod handle 335 and/or to prevent premature deployment ofthe medical implant prior to final deployment. A delivery rod handle 335is typically connected to distal (back) part of the Delivery rod 125(FIG. 1). The Delivery rod handle 335 may include rails 352 orindentations, and rail release points 350, to enable the controlledsliding or maneuvering of the pivot grip 345 into the Delivery rodhandle. Pivot grip 345 may include leader elements 385 to enable smoothand controlled maneuvering along rails 352 towards rail release points350.

As can be seen in FIG. 8D, gripping mechanism 385 may be coupled topivot grip 345, to provide a clear, usable mechanism optionally with asafety warning and/or textual direction (e.g., “Hold Firmly”) to helpenable the practitioner to safely execute the Delivery rod controllingand anchoring processes.

It is expected that during the life of a patent maturing from thisapplication many relevant devices and methods will be developed and thescope of the term a catheter, a rod, and a wire is intended to includeall such new technologies a priori.

As used herein the term “about” refers to ±10%.

The terms “comprises”, “comprising”, “includes”, “including”, “having”and their conjugates mean “including but not limited to”. This termencompasses the terms “consisting of” and “consisting essentially of”.

The phrase “consisting essentially of” means that the composition ormethod may include additional ingredients and/or steps, but only if theadditional ingredients and/or steps do not materially alter the basicand novel characteristics of the claimed composition or method.

As used herein, the singular form “a”, an and “the” include pluralreferences unless the context clearly dictates otherwise. For example,the term “a compound” or “at least one compound” may include a pluralityof compounds, including mixtures thereof.

The word “exemplary” is used herein to mean “serving as an example,instance or illustration”. Any embodiment described as “exemplary” isnot necessarily to be construed as preferred or advantageous over otherembodiments and/or to exclude the incorporation of features from otherembodiments.

The word “optionally” is used herein to mean “is provided in someembodiments and not provided in other embodiments”. Any particularembodiment of the invention may include a plurality of “optional”features unless such features conflict.

Throughout this application, various embodiments of this invention maybe presented in a range format. It should be understood that thedescription in range format is merely for convenience and brevity andshould not be construed as an inflexible limitation on the scope of theinvention. Accordingly, the description of a range should be consideredto have specifically disclosed all the possible subranges as well asindividual numerical values within that range. For example, descriptionof a range such as from 1 to 6 should be considered to have specificallydisclosed subranges such as from 1 to 3, from 1 to 4, from 1 to 5, from2 to 4, from 2 to 6, from 3 to 6 etc., as well as individual numberswithin that range, for example, 1, 2, 3, 4, 5, and 6. This appliesregardless of the breadth of the range.

Whenever a numerical range is indicated herein, it is meant to includeany cited numeral (fractional or integral) within the indicated range.The phrases “ranging/ranges between” a first indicate number and asecond indicate number and “ranging/ranges from” a first indicate number“to” a second indicate number are used herein interchangeably and aremeant to include the first and second indicated numbers and all thefractional and integral numerals therebetween.

As used herein the term “method” refers to manners, means, techniquesand procedures for accomplishing a given task including, but not limitedto, those manners, means, techniques and procedures either known to, orreadily developed from known manners, means, techniques and proceduresby practitioners of the chemical, pharmacological, biological,biochemical and medical arts.

As used herein, the term “treating” includes abrogating, substantiallyinhibiting, slowing or reversing the progression of a condition,substantially ameliorating clinical or aesthetical symptoms of acondition or substantially preventing the appearance of clinical oraesthetical symptoms of a condition.

It is appreciated that certain features of the invention, which are, forclarity, described in the context of separate embodiments, may also beprovided in combination in a single embodiment. Conversely, variousfeatures of the invention, which are, for brevity, described in thecontext of a single embodiment, may also be provided separately or inany suitable subcombination or as suitable in any other describedembodiment of the invention. Certain features described in the contextof various embodiments are not to be considered essential features ofthose embodiments, unless the embodiment is inoperative without thoseelements.

Although the invention has been described in conjunction with specificembodiments thereof, it is evident that many alternatives, modificationsand variations will be apparent to those skilled in the art.Accordingly, it is intended to embrace all such alternatives,modifications and variations that fall within the spirit and broad scopeof the appended claims.

All publications, patents and patent applications mentioned in thisspecification are herein incorporated in their entirety by referenceinto the specification, to the same extent as if each individualpublication, patent or patent application was specifically andindividually indicated to be incorporated herein by reference. Inaddition, citation or identification of any reference in thisapplication shall not be construed as an admission that such referenceis available as prior art to the present invention. To the extent thatsection headings are used, they should not be construed as necessarilylimiting.

1. A coupling device, set to be linked to an interventional deliverysystem, for coupling and releasing a medical implant, comprising: agenerally tubular channel sized and shaped to be conducted in anintravascular catheter; and a pivot extended in and along said generallytubular channel having a distal end comprising a lower surface forapplying pushing force on a medical implant and an upper surface,mounted above said lower generally tubular surface and having at leastone niche for receiving at least one anchoring element of said medicalelement so that a tip of each said anchoring element is placed betweensaid lower and upper surfaces.
 2. The coupling device of claim 1,wherein said generally tubular channel is sized and shaped to cover saidpivot and said medical implant so as to fasten said at least oneanchoring element between said upper and lower generally tubularsurfaces.
 3. The coupling device of claim 1, wherein said pivot iscoated with a polymer to provide a supportive structure.
 4. The couplingdevice of claim 1, wherein said medical implant is coupled to said pivotwithout and direct mechanical connection.
 5. The coupling device ofclaim 1, wherein said pivot is mechanically connected to a controlmechanism facilitating the retrieving or repositioning of said medicalimplant into said generally tubular channel.
 6. The coupling device ofclaim 1, wherein said pivot is mechanically connected to a safetymechanism for requiring a verification action of the user before adeployment of said medical implant.
 7. The coupling device of claim 1,wherein said distal end is curved so that said tip is directedsubstantially toward said upper surface when respective said anchoringelement being placed between said lower and upper surfaces.
 8. A methodfor coupling a medical implant, the method comprising: providing acoupling device comprising a generally tubular channel sized and shapedto be conducted in an intravascular catheter and a pivot extended in andalong said generally tubular channel having a distal end comprisingsubstantially parallel lower and upper surfaces having a gaptherebetween, said upper surface having at least one niche; placing atleast one anchoring element of a medical implant in proximity to saiddistal end so that at least a tip of said at least one anchoring elementimplant is placed between said lower and upper surfaces and so that saidat least one anchoring element passing through said upper surface; andencircling said medical implant using said generally tubular channel. 9.The method of claim 8, wherein said medical implant having an elasticblocking element having compressed and uncompressed states, saidencircling comprising covering said elastic blocking element in saidcompressed state.
 10. The method of claim 9, further comprisinguncovering said at least one anchoring element so as to allow outwardtilting thereof.
 11. The method of claim 9, wherein said medical implantis discoupled by: uncovering said at least one anchoring element, androtating said pivot in relation to said generally tubular channel. 12.The method of claim 9, wherein said placing comprises: attaching animplant adaptor containing said medical implant in front of distal endof said generally tubular channel, performing said placing, and pullingsaid pivot into said generally tubular channel.
 13. A coupling device,set to be linked to an interventional delivery system, for coupling andreleasing a medical implant, comprising: a generally tubular channelsized and shaped to be conducted in an intravascular catheter; and apivot extended in and along said generally tubular channel having adistal end comprising a fastening element for coupling with acomplementary fastening element of a medical implant.
 14. The couplingdevice of claim 13, wherein said pivot, said fastening element, and saidcomplementary fastening element have a common diameter.